This is a proposal from the Columbia University/New York State Psychiatric Institute (NYSPI) Substance Abuse Research Group (CU-SA) in collaboration with the Division of Research at the Long Island Jewish(LIJ)- Hillside Hospital and four well-respected community-based treatment organizations (CBOs), the St. Lukes-Roosevelt Hospital, Bridge Plaza-Narco Freedom, Inc., and the North Shore-Long Island Jewish Health system, as well as the therapeutic community, Phoenix House. This collaboration is a partnership (CU PARTNERS) which will work cooperatively with other nodes in the NIDA Clinical Trial Network (CTN). CU PARTNERS have a full range of expertise in substance abuse treatment research essential for participation in the Clinical Trials Network (CTN). In addition, CU PARTNERS would offer a number of relatively unique strengths to the CTN, including expertise in research assessment, treatment of comorbid psychiatric disorders in substance abusers, child and adolescent psychiatry, design of clinical trials, HIV risk reduction, combined pharmacologic and behavioral therapy, behavioral science, and national drug policy. Treatment research over recent decades has led to the development of a number of pharmacotherapies and behavioral therapies for various drug dependence problems. Yet, for the most part, these newer treatments have not seen widespread use. The proposed node, and the national Network of which it would be a part, will initiate and implement large, multisite, randomized clinical trials, which will be conducted in community-based treatment programs (CTPs) affiliated with our CBOs. Treatments and evaluations will be carried out by the staff of the CTPs. The aims of these trials will be to evaluate whether the efficacy of the newer therapies generalizes to "real world" treatment settings, to disseminate these treatments and foster their appropriate use, and to understand the problems which may interfere with the successful adaptation of newer treatments. A larger aim is to have community-based programs and practitioners participate as full partners in the research endeavor, both to infuse the Nation's treatment system with an evidence-based orientation, and to ensure that research itself is designed to respond to clinical needs.